Here are some options you can discuss with your doctor, including some common remedies you can try at home. (1,2) If they do bother you, some at-home remedies may help you deal with them.
Using a Water Flosser
One of the best methods recommended by doctors for dislodging tonsil stones is doing so with a water flosser. It’s a great way to remove them without gagging, and it doesn’t involve any sharp implements. “It’s the safest noncontact method,” says Jennifer Setlur, MD, an otolaryngologist at Massachusetts Eye and Ear in Boston. (2)
Gargling With Salt Water
When it comes to tonsil stones, there are a few benefits to vigorously gargling using salt water. It can help relieve throat discomfort or pain, and it can dislodge tonsil stones. It can even help get rid of bad breath odor caused by tonsil stones. Gargling can be particularly useful after eating to prevent food and debris from getting caught in the tonsillar crypts, the small, naturally occurring crevices in your tonsils. (1)
Pushing or Squeezing Out Stones
Many people try to physically remove these stones on their own by pushing or squeezing out these growths with an object. If you do try to remove a stone yourself, do not use a sharp object (such as a pen, pencil, toothpick, knife, or safety pin) to do so, says Dr. Setlur. “There is risk for injury to the tonsil and bleeding,” says Setlur. “There is a risk for vascular injury.” Even using a finger or toothbrush could scratch your tonsils, so if you do try this method of removal, try using a cotton swab. Using an object for stone removal can work, but putting pressure on the tonsils can also trigger the gag reflex in some people, says Aaron Thatcher, MD, a clinical assistant professor at the University of Michigan Medicine. If you do decide to remove the stones yourself, be sure to push the dislodged stones forward, toward the opening of your mouth, and away from your throat. (1,2)
Yes, Sometimes Tonsil Stones Do Go Away on Their Own
In some cases, tonsil stones can go away on their own, says Setlur. “Your tonsils can change, becoming more cryptic [meaning they develop more crevices and pits] in the late teens and early twenties, and shrinking as we get older.” But, if none of the above home remedies work for you or you have tonsil stones that are too large or too deeply embedded in the tonsils for you to remove them yourself, you may want to consider seeing an otolaryngologist (an ear, nose, and throat doctor), Setlur says. “Most dentists or general practitioners may not want to manipulate this area and may recommend an ENT or oral surgeon.” But your doctor can help you decide if more serious treatment is needed. RELATED: Everything You Need to Know About Preventing Tonsil Stones If your tonsil stones are on the severe end of the spectrum — if you’re constantly working to remove tonsil stones that persistently grow back or you’re coughing up tonsil stones every couple of days, for instance — you may want to talk to your doctor about surgical options, says Thatcher. RELATED: What Causes Tonsil Stones in the First Place You should also see your doctor right away if you spot any of these symptoms, which could be signs that you have an infection or another more serious medical problem: (1,2,3)
Tonsils that are enlarged or look very redAny asymmetry in the tonsils (if one side is bigger or looks different from the other or if you are experiencing more pain on one side)Trouble swallowingFeverPersistent sore throatBleeding in the tonsilsPus coming from the tonsilsPain (including ear pain)Enlarged tonsilloliths that interfere with breathingStomachache or vomiting
Tonsillectomy
A tonsillectomy is the complete removal of the tonsils. Like any surgical procedure, there are risks of complications such as bleeding and infection. It’s also a painful procedure that can involve two or more weeks of moderate to severe pain, says Thatcher. The tonsils also play an important role in keeping harmful bacteria and viruses out of your body by acting as sentinels and preventing them from entering through your mouth, and should only be removed when absolutely necessary. (1,2,3) “They are part of the immune system,” says Setlur. The bottom line: Your doctor may recommend this surgery if the tonsil stones are severely affecting your quality of life, and other methods to keep your tonsil stones in check are not working. (1,2) “It’s a high-risk solution for a low-risk problem,” Setlur adds.
Laser Tonsil Cryptolysis
In this surgery, a surgeon uses a laser to remove the tonsil crypts by resurfacing those areas (but not removing the full tonsils). A 2013 review of 500 cases involving this procedure found that the advantages of this surgery over tonsillectomy included no need for general anesthesia (a lower, local dose is all that is required), not having to remove the tonsils, enabling doctors to target only the areas where cryptic pockets are, reduced risk of bleeding, less pain after surgery, and shorter recovery time. (4)
Coblation Tonsil Cryptolysis
For this procedure, doctors use radio-frequency energy and salt water to remove the crypts and crevices in the tonsils where tonsil stones have formed. (5) It has all the aforementioned advantages of laser tonsil cryptolysis over tonsillectomy. Additionally, it allows the doctor to operate at a lower temperature than a laser requires, so there are fewer risks than with the laser procedure (such as potential airway fire, retinal damage, and facial burns).
